I have mild hypertension. It's probably genetic and not particularly serious. It can be easily controlled by a pill that is taken by millions of Americans.
This afternoon, my blood pressure is rising fast, and it is not because I am out of pills.
There is little that I understand about our health care system. Perhaps that is by design.
On May 1, because of my early retirement, I went off our work health plan. It was with Blue Cross. We paid about $1000 a month for family coverage. It worked fine because we rarely get sick. Now that I am retired, but not old enough for government coverage, I need my own policy.
I applied for a policy with a company suggested by an agent. Blue Cross, of all things. Since I am never sick, I was accepted. Since I am never sick, I chose a high-deductible. I don't really understand the policy of course, but I think that I pay for the first $5,600 worth of illness each year. The government will not tax me for that.
Monthly premiums for an individual are $340. Blue Cross is betting that is all gravy. I certainly hope that they are right.
I pay for my own prescriptions, but I have to run them through the Blue Cross bureaucracy to get a discount. Big insurance companies can do better with big drug companies than individuals can. They "negotiate."
I have been getting my Benicar through Blue Cross for years. I tried a generic substitute once, but had a coughing reaction to it, so back to Benicar. Last week was the usual time for a refill. As she has for the past decade or so, Kathleen drove the family car down to the Target Pharmacy to get the Benicar.
No dice. Insurance won't "pay." Now what? The new price is $3 a pill.
Stunned, I called the insurance company number on my brand new ID card and explained. I was politely told I needed to call the pharmacy and have them fax a "formulary override" form to my doctor's office. This form was then to be filled out and sent back to the insurance company. The insurance company would then ponder the efficacy of the formulary overide and if it chooses to, it will send a fax to the Target pharmacy authorizing the override.
Okay. These companies are mega-bureaucracies and they have their reasons. Four separate private businesses derive income from my mild hypertension, each protected by the government. They do not exist to cure me, they exist to make money. I get that. But it is now Saturday and I am out of Benicar.
The folks at Target haven't got their fax yet. No fax, no pills. Unless, of course, you wish to buy them ala carte. How much?
It is now $5 per pill.
I have mild hypertension. I do not have cancer. I do not have a heart condition. Or Parkinson's. I will be fine, don't feel sorry for me. Just think of others in actual difficult circumstances.
And know this. Soon you will be bombarded with messages about how great our health care system is and what a horror would be created if the government took over its management. Millions of dollars will be spent to convince you that the status quo, with a tweak or two, is still the best ticket for America. Millions more will be spent on elected representatives to help them keep their minds in line.
And where will these millions come from?
From saps like me, spending $5 apiece for Benicar.
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(Thanks for listening. I can feel my blood pressure going down already. Heck, with a little more weight loss and exercise, maybe I can get off the meds entirely. As I said, it's not cancer.)
